AB0477 EFFICACY AND SAFETY OF UPADACITINIB IN RHEUMATHOID ARTHRITIS: REAL-LIFE EXPERIENCE FROM A MULTICENTRIC ITALIAN STUDY
Authors: C. Baldi, S. Parisi, P. Falsetti, F. Nacci, M. C. Ditto, M. D’alessandro, M. Capassoni, J. Sota, E. Conticini, C. L. Peroni, L. Cometi, E. Fusaro, B. Frediani, S. Guiducci
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Upadacitinib (UPA), a JAK inhibitor engineered for a greater selectivity towards JAK1, has demonstrated a favourable benefit-to-risk profile in rheumatoid arthritis (RA) patients with an inadequate response to cDMARDs and biologic agents in randomized clinical trials. However, real-life data on its efficacy and safety are limited. We herein provide the first prospective multicentre experience on UPA efficacy and safety profile in RA in a real-life context, focusing on clinimetric and ultrasonographic (US) data. <h3>Objectives</h3> The primary aim of the study was to assess changes in clinimetric and US scores between different time point observations (baseline, 1 month, 3 months and 6 months). Secondary aims were to: (i) estimate the impact of biologic line of treatment and of concomitant therapies on response to therapy; (ii) explore changes in laboratory parameters; (iii) find potential predictive factors associated with response to therapy. <h3>Methods</h3> Medical records of consecutive RA patients treated with UPA and referred to three Italian tertiary Centers were prospectively reviewed. Adult patients meeting ACR/EULAR classification criteria for RA were enrolled. <h3>Results</h3> Our real-life experience confirms the efficacy in terms of clinical and US improvement as well as displaying a good safety profile. The combination therapy with a conventional immunosuppressants predicts a significantly lower clinical and US improvement, likely reflecting a more severe and aggressive course worthy of ad-hoc and more in-depth investigation. An improvement in the SDAI and DAS28CRP was observed, already from the first month of therapy and has been maintained over time. In conclusion, these results demonstrated the short term efficacy of Upadacitinib 15 mg for up to 6 months and providing a prompt improvement of PROs. Even if further studies are needed to clarify those results, these novel findings may provide new insight for the management of UPA treatment in clinical practice. <h3>Conclusion</h3> Our real-life experience confirms the efficacy in terms of clinical and US improvement as well as displaying a good safety profile. The combination therapy with a conventional immunosuppressants predicts a significantly lower clinical and US improvement, likely reflecting a more severe and aggressive course worthy of ad-hoc and more in-depth investigation. An improvement in the SDAI and DAS28CRP was observed, already from the first month of therapy and has been maintained over time. In conclusion, these results demonstrated the short term efficacy of Upadacitinib 15 mg for up to 6 months and providing a prompt improvement of PROs. Even if further studies are needed to clarify those results, these novel findings may provide new insight for the management of UPA treatment in clinical practice. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.